Public health communication professional development opportunities and alignment with core competencies: an environmental scan and content analysis

Abstract Introduction: Communication is vital for effective and precise public health practice. The limited formal educational opportunities in health communication render professional development opportunities especially important. Competencies for public health communication describe the integrated knowledge, values, skills and behaviours required for practitioner and organizational performance. Many countries consider communication a core public health competency and use communication competencies in workforce planning and development. Methods: We conducted an environmental scan and content analysis to determine the availability of public health communication professional development opportunities in Canada and the extent to which they support communication-related core competencies. Three relevant competency frameworks were used to assess the degree to which professional development offerings supported communication competency development. Results: Overall, 45 professional development offerings were included: 16 “formalized offerings” (training opportunities such as courses, webinars, certificate programs) and 29 “materials and tools” (resources such as toolkits, guidebooks). The formalized offerings addressed 25% to 100% of the communication competencies, and the materials and tools addressed 67% to 100%. Addressing misinformation and disinformation, using current technology and communicating with diverse populations are areas in need of improved professional development. Conclusion: There is a significant gap in public health communication formalized offerings in Canada and many of the materials and tools are outdated. Public health communication professional development offerings lack coordination and do not provide comprehensive coverage across the communication competencies, limiting their utility to strengthen the public health workforce. More, and more comprehensive, professional development offerings are needed.


Introduction
With the field of public health constantly evolving due to new knowledge from research and practice and changing technology, effective communication is critical, especially during crises. 1 Effective communication is also central to the design and implementation of public health initiatives, which impact adoption of recommended health behaviours, especially among those in underserved population groups. 2

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There have been widespread calls to improve the Canadian public health system, including updating core competencies for public health and related professional development opportunities 1,[3][4][5] as well as public health communication. 6,7Changes in the information ecosystem have altered methods of communication and increased the threat of misinformation, undermining trust in public health communication. 8,9his is especially apparent in the context of social media, which is an important tool for delivering public health messages. 1,9thout the opportunities to continually update and adapt their communication competencies and skills, public health practitioners risk losing their credibility and the public's trust, negatively affecting the health of Canadians. 1 Professional development allows for the enhancement of existing skills and behaviours and acquisition of new knowledge and attitudes in order to meet workforce demands.
In 2008, the Public Health Agency of Canada (PHAC) published Core Competencies for Public Health: Release 1.0 ("PHAC core competencies") after extensive consultation with public health researchers and practitioners across the country. 10The 36 PHAC core competencies are organized into seven categories, one of which is communication. 10At the time of writing, the PHAC core competencies were undergoing renewal and modernization.Because of the age of the current PHAC core competencies, other public health competency frameworks may help inform Canadian public health workforce planning.
Health Promotion Canada has a framework for discipline-specific competencies for health promotion ("HPC competencies") based on the PHAC core competencies. 11The Council on Linkages Between Academia and Public Health Practice ("Council on Linkages") in the USA has foundational core competencies for public health practitioners; 12 these core competencies have been regularly revised since their release in 2001 and provide an up-todate framework that reflects modern communication requirements, including addressing the infodemic and culturally appropriate communication. 12ere are similarities across the three competency frameworks, including tailoring communication to various audiences, choosing the right communication channel(s), mobilizing communities and using technology effectively.The extent to which communication competencies from these frameworks inform professional development opportunities for public health communication is unknown.
Gaps have been identified in the public health communication courses offered by the master of public health programs in Canada. 13,14Also, research into online continuing education programs found that only about half the courses offered in 2015 included communication as a topic. 15lthough several online courses are available for public health professionals in Canada, Jung et al. 15 found that these did not provide comprehensive coverage of the PHAC core competencies, including within the communication domain; nor were they readily accessible through a central online database.
Given the significance of communication in public health practice and its focus in public health competency frameworks, it is important to understand the opportunities and resources currently available and how these align with the relevant competency frameworks.Identifying current professional development offerings for public health practitioners will also highlight the opportunities for building workforce competence and communication capacity.This current research aims to determine the availability of public health communication professional development opportunities and the extent to which they support core competencies in communication.The objectives of this research include: • using an environmental scan to identify currently available Canadian professional development opportunities relevant to public health communication; and • conducting a content analysis to describe how these identified professional development opportunities align with communication competencies from the relevant frameworks (PHAC core competencies, HPC competencies, and Council on Linkages competencies).

Methods
We conducted an environmental scan to determine the current professional development landscape that supports public health communication competencies in the Canadian workforce.Our search methods were guided by previous research on competencies for public health and continuing education. 16,17Following the steps outlined by Bengtsson 18 and Krippendorff, 19 we analysed the content of all the professional development opportunities identified in the scan to determine their nature and the degree to which they support the development of public health communication competency.

Search strategy
First, the research team searched, by way of a Google site search (site:URL search terms) using the term "health communication," the entire contents of websites of public health organizations known to them.
Next, we conducted an Internet search using the Google search engine and the following search terms: "health communication," "public health," "continuing education," "Canada."A subsequent search used the search terms "health communication," "public health," "course," "Canada."Consistent with methodological examples and recommendations, we reviewed the first 10 pages of results of each search. 17,20he same two searches were also run using the Ontario Public Health Libraries Association custom Google search engine, 21 the grey literature database CABI Global Health 22 and the custom Google search engine developed by Queen's University Library. 23Other resources known to the research team were also included.

Search criteria
Two researchers (MM and JEM) independently reviewed the professional development offerings for relevance to the following inclusion and exclusion criteria and resolved all conflicts by discussion.For a professional development opportunity to be included, it had: • to be offered or be available within the last 12 months (materials and tools may still be available online long after their initial publication); • to be widely available and applicable to Canadian public health practitioners; • to reoccur as a multistep program offered to different public health organizations and/or allow repeated access through online platforms; • to be in English; • to be offered in Canada or be available to Canadians; • to be relevant to Canadian public health infrastructure and governance; and • to be related to public health communication.
Included were "formalized offerings," that is, training opportunities such as certificate programs, courses, graduate programs, summer institutes, webinars and online learning programs, and "materials and tools," that is, resources such as guidebooks, white papers, expert panel reports, toolkits, guidelines and briefing notes, conference proceedings, blog posts, factsheets, toolkits and websites.
Offerings were excluded if they were single occurrence webinars, conferences or workshops; and/or limited in geographical relevance or offered in a relatively small geographical area or organization (e.g. one local public health unit).

Data collection
One researcher (HW) collected the data between 13 November 2022 and 6 December 2022 and recorded the information on an Excel spreadsheet. 24The following information was collected for each formalized offering: name, description, type (e.g.certificate program, webinar), format (e.g.hybrid, online), intended audience, time commitment, cost, the institution providing the offering, the country providing the offering and its geographical reach, date last offered, currently offered (Y/N), the URL, the search date and the search source.The following information was collected for materials and tools: title, author, description, type (e.g.guidebook, toolkit), intended audience, location, date, the URL, the search date and the search source.

Content analysis
The communication-related competencies from the PHAC core competencies, 10 the HPC competencies 11 and the Council on Linkages 12 were used to assess the degree to which the professional development offerings support public health communication competencies (Table 1).
Three researchers (MM, HW and JEM) created a codebook describing key variables identified during data collection and the communication-related competencies from the frameworks described above.(This codebook is available at https://osf .io/fjtdc/.) Subvariables for each competency that reflected the named audiences, channels, tools and techniques were also captured.Professional development opportunities could be coded for the overall competency and may or may not be coded for the various subvariables depending on whether the specific audiences, channels, tools and techniques were covered.The codebook was validated prior to coding.Two researchers (HW and MM), working independently, coded the full dataset, discussing and resolving all conflicts along the way.

Statistical analysis
Descriptive statistics (frequencies) were calculated using Excel 24 to assess how each of the professional development opportunities support the communication competencies.We used RAWGraphs 25 to present the data visually.

Results
The environmental scan uncovered a total of 45 professional development opportunities related to public health communication.Of these, 16 (36%) were formalized offerings and 29 (64%) were materials and tools.Three of the 16 formalized offerings were available and analyzed in full.The remaining 13 were analyzed based on the summary information available (most often because they were behind a paywall).All materials and tools were available and analyzed in full.
For details on the formalized offerings and materials and tools, refer to https://osf.io/fjtdc/.

Characteristics of professional development opportunities
Just over half of the 16 formalized offerings (n = 9; 56%) and most of the 29 materials and tools (n = 26; 90%) originated from Canada (Table 2).While all the formalized offerings were offered in the last 12 months (and thus met our inclusion criteria), only one (3%) set of materials and tools was published in the last 12 months and only six (21%) in the last 5 years, although all were available online within the last 12 months, thus meeting our inclusion criteria.

Competencies within professional development opportunities
Overall, across the professional development opportunities (formalized offerings and materials and tools combined; see Table 1), competencies related to tailoring information (n = 44; 98%), using different communication strategies (n = 43; 96%) and communicating with internal and external audiences (n = 42; 93%) were the most supported; competencies related to misinformation and disinformation (n = 12; 27%), current technology (n = 25; 56%) and using media (n = 33; 73%) were the least supported (data not shown).Figure 2 shows the alignment of the professional development offerings with the competency frameworks broken down by formalized offerings (n = 16) and materials and tools (n = 29).a The Council on Linkages Between Academia and Public Health Practice 12 suggests that public health professionals require four overall communication skills.These are made up of 23 subcompetencies.For ease of use, these subcompetencies have been combined into the four overall competencies shown.
(n = 12; 75%) of formalized offerings (Table 3).Communication skills was similarly supported by all of the materials and tools and almost two-thirds (n = 10; 63%) of formalized offerings.Mobilizing people was slightly less supported with 90% (n = 26) of materials and tools and 50% (n = 8) of formalized offerings addressing it.The least supported competency was current technology with 66% (n = 19) of materials and tools and 38% (n = 6) of formalized offerings addressing it.
The types of intended audiences were less frequently addressed by formalized offerings compared to materials and tools (Table 3), with colleagues the least addressed audience type.Professional development opportunities most often addressed interpreting information for communities, while professional audiences were least covered.Further, social marketing techniques for mobilizing individuals and communities were not well addressed by the professional development opportunities.Finally, formalized offerings infrequently covered specific technologies identified in the competencies, while materials and tools addressed using websites and social media in approximately half of the resources that addressed this competency.

Alignment with Council on Linkages communication competencies
Overall, the materials and tools had more comprehensive alignment with the Council on Linkages communication competencies based on the information available, except for addressing misinformation and disinformation (Table 5).This competency subvariable had the lowest support from professional development opportunities with only four (25%) of formalized offerings and eight (28%) of materials and tools addressing misinformation and disinformation.
Although the remaining three competencies (communication strategies, internal/ external audiences, facilitate communication) were broadly addressed by many professional development opportunities, there was less focus on some key elements.Specifically, while 17 (59%) of materials and tools addressed communicating with internal audiences, only two (13%) formalized offerings addressed this element of the competency.

Discussion
This  We found 45 offerings related to public health communication of which 16 were formalized offerings (training opportunities, e.g.certificate programs, courses, webinars) and 29 were materials and tools (resources, e.g.guidebooks, toolkits, reports).Less than one-quarter of the materials and tools were published in the last 5 years.The older age of some materials and tools may have contributed to the competency gaps in current technology and in addressing misinformation and disinformation.Most often, formalized offerings focussed on knowledge mobilization while materials and tools focussed on general health communication.
Professional development offerings were not developed or coordinated by a governing body, but were offered by different organizations and agencies across Canada and the USA.Overall, the formalized offerings address fewer competencies relative to the materials and tools; however, this may be, at least in part, because we were only able to analyze summary materials for the majority of formalized offerings whereas all materials and tools were available and analyzed in full.
Competencies are the integrated knowledge, skills, attitudes/values and behaviours that public health practitioners and organizations must possess for effective public health practice. 26Public health organizations can take competencies into account when recruiting personnel, assessing job performances and identifying professional development needs. 26Workforce training and continuing education are an essential part of competency development, especially when there is a lack of graduate training options in communication and other competencies, as was found in Canada. 14,15The Canadian Public Health Association has recommended workforce training in modernized competencies as key for strengthening the public health system. 1,27PHAC used to offer Skills Online, an eight-module professional development   program that directly supported the core competency categories. 28The results of this study show that the professional development opportunities currently available do not cover all the PHAC core competencies, with formalized offerings averaging 2. 25  Compared to the formalized offerings, the materials and tools were more aligned with the communication-related core competencies; however, practitioners need to seek out these resources, without the benefit of a facilitated structure such as could be expected from a course.Diverse effective training includes online courses, mentorship, just-in-time training and communityengaged training, through academia, government, community and other partnerships. 29Materials and tools for public health communication would be less likely to reflect these pedagogical practices.
Further, recent research found that fewer than half of the master of public health  programs in Canada offer courses that focus on health communication, and none specialize in health communication. 14As with professional development, a systematic approach to enhancing communication competence in the public health workforce is needed, and master of public health programs should include targeted health communication education taught by faculty members with the relevant expertise.In addition, curricula need to be regularly reviewed to make sure they are aligned with contemporary competencies and current public health needs.
Comprehensive professional development opportunities that address contemporary public health communication needs will strengthen our capacity and ensure the availability of a skilled workforce.In contrast to current offerings in Canada, the selection of trainings in public health communication for students and practitioners in the USA is large and comprehensive.The Public Health Foundation offers the TRAIN Learning Network; the foundation and the New England Public Health Training Center have a number of courses related to communication that are mapped to the Council on Linkages' core competencies for public health professionals. 12,30here are also 65 schools in the USA that, between them, offer 77 programs on health communication. 31They could also provide a roadmap for comprehensive training and professional development aligned with core competencies and pedagogy for effective training in Canada.
Overall, the professional development offerings had strong alignment with the communication-related PHAC core competencies, with nearly half (49%) addressing all four competencies.One communication core competency, the PHAC core competency, "current technology" (#6.4), was not widely addressed by formalized offerings but had better coverage within materials and tools, although leveraging technology rather than teaching practitioners how to effectively use it tended to be mentioned.Digital technologies are vital to public health communication, as was evidenced during the COVID-19 pandemic when social media, online big data sources, data visualization, artificial intelligence and digital platforms (e.g.video conferencing software) became increasingly important. 32Thus, it is critical that the core competencies not only reflect the scope and complexity of digital technologies that should be used by public health in communication initiatives but also that they be mapped to professional development opportunities that teach the technologies to practitioners.
As previously mentioned, the PHAC core competencies are undergoing renewal and modernization, with an estimated launch scheduled for 2024.The Chief Public

Strengths, limitations and future research
The search strategy was designed to capture as many professional development offerings meeting our inclusion criteria as possible.The search consisted of English language results only, and some web content was inaccessible without an organization membership.Access to the full details of formalized offerings was often not possible without enrolling in the course; therefore relevant data were mostly extracted from summary information, which may have biased the results given that materials and tools often presented information in full.Further, while formalized offerings

Abbreviations:
Abbreviations: Council on Linkages, Council on Linkages Between Academia and Public Health Practice; HPC, Health Promotion Canada; PHAC, Public Health Agency of Canada.Notes: The legend provides two reference points (smallest circle = 4 offerings; largest circle = 29 offerings) visualized in the figure.
FIGURE 1 Formalized offerings and materials and tools by host organization and delivery mode

Note:
The legend provides two reference points (smallest circle = 1 offering, and largest circle = 5 offerings) visualized in the figure.

FIGURE 2
FIGURE 2Alignment of professional development opportunities (formalized offerings and materials and tools combined) with communication competencies

TABLE 1 Summary of communication competency statements from three frameworks Competency short name / framework Competency statement
Communicate effectively with individuals, families, groups, communities and colleagues.Apply communication methods and techniques to the development, implementation and evaluation of health promotion action.Use the media, information technologies and community networks to receive and communicate information.
Sources: Public Health Agency of Canada 10 ; Pan-Canadian Committee on Health Promoter Competencies 11 ; Council on Linkages Between Academia and Public Health Practice 12 .

TABLE 5 Alignment between professional development opportunities and Council on Linkages communication competencies and subvariables, including specific audiences, channels, techniques and tools in each competency
12uncil on Linkages Between Academia and Public Health Practice.12Abbreviation:Council on Linkages, Council on Linkages Between Academia and Public Health Practice.Because multiple subvariables were possible, totals can exceed 100%.Public health organizations and associations play key roles in workforce development and are aware of community-level needs and practitioner competencies through their connection to the field and monitoring and evaluating of key issues.As such, they are in the best position to clarify the public health needs of today and anticipate the needs of tomorrow.Public health schools, meanwhile, bring expertise in pedagogy and competency-based education.Such partnerships would help produce training opportunities that are tailored to organization and practitioner needs, including format, timing and focuses.Further, public health organizations and associations could provide comments and input to public health schools on what they anticipate needing in the future, which is important because of the lead time required to build curriculum and expertise in the future public health workforce. Source:a